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General NPI Number Information
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NPI Number | 1932459419
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Entity Type | Organization
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Legal Business Name | ROBERT M EASTON JR OD PA
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 1560 EAST OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-4425
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Country | US
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Telephone | 954-564-2025
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Fax | 954-564-3869
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Provider Business Mailing Address
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Address Line | 1560 EAST OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-4425
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Country | US
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Telephone | 954-564-2025
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Fax | 954-564-3869
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. ROBERT MORRELL EASTON JR.
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Credential | O.D., F.A.A.O.
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Telephone | 954-564-2025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC001736
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC001736
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License Number State | FL
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